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Ep. 70 - LiveWell Talk On...Breastfeeding (Leeann Moses, RN)

episode 70

Ep. 70 - LiveWell Talk On...Breastfeeding

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Host: Dr. Dustin Arnold, chief medical officer, UnityPoint Health - St. Luke's Hospital

Guest: Leeann Moses, RN, lactation specialist, St. Luke's Birth Care Center

Dr. Arnold:
This is LiveWell Talk on breastfeeding. I'm Dr. Dustin Arnold, chief medical officer at UnityPoint Health - St. Luke's Cedar Rapids, Iowa. It's world breastfeeding week and returning to the podcast is Leeann Moses, the lactation specialist at Women's and Children's Center here at St. Luke's. Last time you joined me, we were talking about COVID-19 and breastfeeding, and we kind of mission creeped into the just the general breastfeeding and lactation specialist you have. So we wanted to have you back, particularly during world breastfeeding week.

Leeann Moses:
Thank you.

Dr. Arnold:
Which you know, I was not aware of that.

Leeann Moses:
It's always the first week of August. You'll remember that.

Dr. Arnold:
Yes. I'm sure. So we want to kind of hit the high points and really cover the questions that you see the most often. Because some people, no matter the industry, they're a little afraid to ask questions sometimes. So first talk about what are the benefits of breastfeeding?

Leeann Moses:
So there's many benefits for both the mom and the baby. For the baby itself, it actually prevents many viral and bacterial infections. Breastmilk actually lines the gut of the intestinal track and can help prevent all of these things. I think it's pretty amazing. They say only one tablespoon of breast milk has millions of antibodies in it. So that just shows how just this little amount can go such a long way. It can lower the incidences of diabetes, asthma, SIDS, tons of infections.

Dr. Arnold:
Sudden Infant Death Syndrome.

Leeann Moses:
Yes. Yep. Infections list goes on and on for the benefits health wise for the baby. Then for the mother, same thing, it actually can lower for her postpartum depression, because the emotions and the bonding that goes with breastfeeding. Plus it can decrease for her diabetes as well, helps her bring down her weight, which can help bring down her blood pressure. And just the bonding there in general for both of them, is huge. It also has a financial benefit because the breast milk is free, which we all know formula is very expensive. So any little bit you can get to help your family is huge.

Dr. Arnold:
Particularly in these times.

Leeann Moses:
Yeah.

Dr. Arnold:
I think you've listed all the high points. What percentage of women does the milk not come in? If that's the right term.

Leeann Moses:
Yes. Yep. Luckily for most women they can make milk, but that's a very good point. Some women, unfortunately don't make enough for their baby. But for those moms that really still want to do it and are feeling a little discouraged about that, that's the moms I like to tell, like I just mentioned how that one tablespoon goes a long way. So if a mom can only make a little bit, it's still worth it and then she can just kind of fill up the baby with formula if needed. But it's kind of like she gave the baby medicine in her breast milk and then made up the difference in formula. And then yes, there are some women who really the milk just doesn't come in no matter how they try. But we're definitely here to help them and then kind of counsel them on their other options and ways to make feeding their baby best. Because I do like to always throw that in there, fed babies best and we'll help them get there, whether it is, you know, breast milk or formula or whatever they need.

Dr. Arnold:
I'm inferring this, but so you can take a little bit of breast milk and add it to formula and give it to you the baby?

Leeann Moses:
Yes. So it's safe to mix it, but we always tell moms not to, just because we don't want them to not get any of their milk. So say she pumped just a little bit and she poured formula with it. And then she feeds that.

Dr. Arnold:
It might dilute it down to the point that they might lose that benefit that you talked about.

Leeann Moses:
Exactly. Just if they don't finish the bottle. You know, then some of that's missed. So I always tell them, give your milk first and then give the formula after.

Dr. Arnold:
Okay. And if I'm a woman and my breast milk doesn't come in, is there something I should discuss with my doctor? Is there a medical condition that might be present that I need to have checked out?

Leeann Moses:
That could be, that's a very good point. So with their OB, by their six week checkup they should be having with their OB, they could definitely bring that up if their milk's not in, just to make sure. Usually most women there's an underlying condition that cause like infertility and other things that have already been established. And when they're here and we see them, I do always talk to them about that. So if they've had an infertility, that's one where sometimes women don't make enough milk or polycystic ovarian syndrome. Maybe they've had breast surgery or different things like that, that can affect milk supply. So we definitely touch on that with them when they're here. But that is a great point. If their milk really doesn't come in and things aren't going well for them, they could bring it up at their OB just in case. But that's also what we're here for too, not that we diagnose. I'm definitely not a doctor, but we can troubleshoot why maybe their milk isn't in, or you know, what they're missing that they're not making a good supply.

Dr. Arnold:
Yeah. Okay. I was just kind of curious there. So what actual services do you provide?

Leeann Moses:
So as a lactation consultant, there's one of us here every single day. And we see all the patients that deliver here every day or as needed also in the NICU. We also have, especially in our NICU, different nurses who are trained in breastfeeding to help so they can get help the whole time they're here, but then we're available every day. We also have a phone line, so anyone can call in the community and leave us a message and we'll call them back and help them with whatever they need. And that number is 319-369-8944. Like I said, I just leave a voice message because we might be on the floor, but we'll call you back. And then we have, unfortunately, I should pause with coronavirus right now. We do have our classes on hold, but we will start them again. We will. And so we offer a prenatal breastfeeding course, which I highly recommend. I see a big difference in the moms who have taken that when I see them on the floor, because they already know the holds and the form and the different things we're going to need to do over the next couple of days. So I highly recommend that. And then after they go home and they have their baby, they can come back with their baby and we have a support group and we weigh the babies every week. We can check a latch. It's just a really good resource to keep the breastfeeding going as long as they want to. So for now, unfortunately I don't know when they're going to start yet, but they can always call in and ask or watch the websites. And we're hoping to get them in soon.

Dr. Arnold:
Yeah. You would think you'd be able to do something virtually at least.

Leeann Moses:
Actually that's a great thing you brought up. We do have an online virtual appointment now. It's not with us, it's through Telehealth, but it is a lactation consultant that they can kind of video with. And that information is on our website or they can call in and get that from us. It's through insurance, so they have to check with their insurance. But if nothing else, they can always call us for free and we can guide them, hopefully answer their question. But if not, if they really need seen, we can get them to who they need to be seen by. Right now with coronavirus, a lot of the pediatricians in the office, the nurses are helping with weight checks and other things to make sure breastfeeding's going well. So I definitely don't want a woman to feel like they're stuck at home and can't get the help they need because of this.

Dr. Arnold:
Do you think the trend is increasing, as women breastfeeding?

Leeann Moses:
Yes, and I'm happy to say that. A lot of, you know, if you talk to maybe your generation, it was a lot of people bottle fed. Like, my mom did breastfeed me, but we talk about how in that generation bottle feeding was definitely the thing. And it's definitely turned it back more to breast. Here at UnityPoint, our goal is to have 80% and above women breastfeeding. And we're definitely hitting that, so that's exciting. I definitely say yes.

Dr. Arnold:
So I just turned 51, and it seems like I can remember cloth diapers. You know, my mom doing that and having a diaper service. You know, then it was like disposable diapers came in and breast milk. I mean, you know. So everybody's like, I'm not doing this anymore, you know? And they went with the disposable diapers. So I definitely think there's a pendulum swinging there. That's interesting. I mean, I'm sure some women don't have confidence in themselves, just people sometimes don't have confidence in themselves. What do you do to build their confidence with this?

Leeann Moses:
So we'll see them while they're here and then we can help them with their skills, which will make them more confident. If a woman wants, we'll gladly help with them physically to latch and show them the form and get the baby on. And it's so neat. That's something I find rewarding in my job when the baby does get on for the first time and I got to help them. And they are so excited and you can just see it in their face, like I just did this, this is working. So that's huge. And then just talking to them of ways to make it work in their life. You're exactly right with confidence. And just the way our world is now, everyone judges each other. And you know, there's social media and there's things that it's hard. And so just making them feel comfortable in their own skin that they can breastfeed anywhere and how they can make it work with going back to work and different things in their life. Because I hear those kinds of things a lot. Like, well, I can only do it until I work again. Or, you know, I can only do it if nobody's around or things like that. So just talking to them. And everyone's situation's different and giving them options to make it work for them. And hopefully they can walk out of here feeling confident. And if not, you know, that does happen where unfortunately, our patients only stay two or three days. And that's not us, of course that's insurance. So they have to, you know, they have to go home. But just letting them know we're still there so they can call and we can keep them confident and keep this going as long as they would like.

Dr. Arnold:
Now I know the whole donation to the breast milk bank, I almost said blood bank, the breast milk bank. And that's pasteurized. If I'm a mom and I'm pumping, do I have to worry about pasteurizing that, my own milk?

Leeann Moses:
No, that's a good question. So the milk bank—

Dr. Arnold:
That's my job, to ask good questions.

Leeann Moses:
Yes. It's pretty cool. The milk bank obviously tests the mothers and then they test the milk and they pasteurize the milk to make it safe to be donated all over. And I'm pretty proud to say here at UnityPoint, we have that milk. And that's something good for our patients to know, if they choose St. Luke's, that we can give that to anyone's baby who needs it. But for them at home, they don't have to worry about it. What's so cool about breast milk, is it just adjusts to the baby and what they need. And even does that with time. What I mean by that is as the baby gets older, the breast milk in the mother's body adjusts to what that baby needs. Which I think is just phenomenal. And if the mom gets a cold or the baby gets a cold, that breast milk even kind of kicks into heightened gear and makes more antibodies for that baby. So the mother doesn't have to worry about anything like that. Except of course, if she's pumping, she needs to wash her pump parts. And going back to coronavirus, we're saying yes, definitely breastfeed. But wear a mask, wash your hands, wash your pump parts, things like that.

Dr. Arnold:
Yeah. I think the last time we talked, there's still not solid evidence of vertical transmission of breast milk with coronavirus. That still remains the same. What happens after they go home? I mean, like you said, the stays aren't as long as they used to be in the hospital. What happens when they go home?

Leeann Moses:
So we hope for them that they're successfully breastfeeding. The hard part is, women sometimes go home and their milks not in. And then once it comes in, usually breastfeeding gets a lot easier. The baby's getting fuller longer, which is allowing the mom to sleep better. Her nipples, her body's getting more adjusted to breastfeeding, so they're not in as much pain. So it usually gets better. But that's why we say still the call us if they need anything, because now with their milk coming in, comes new questions. We try to address all that with them before they leave. And then of course they will take their baby to the pediatrician for a checkup and they'll be watching the baby's weights to make sure baby's getting enough. So there's a lot of guidance even after home, you should say. And then again, I hope to get our support group back where we watch the baby's weight. Beause that's one of the biggest things with breastfeeding for a mom at home to watch, to make sure baby's getting enough, is the weight. Babies pees and poops, making sure they're having wets and dirties constantly throughout the day. A baby should have six to eight wets daily and hopefully a stool daily. And then contentment, that the baby's eating and content afterwards. You know, not always acting hungry and then a mom can physically feel when her milk comes in. And these are all things again that usually happen after they're home, but it's good for people out there to know those tips. And then we do address that with them when they're here too, so they know that.

Dr. Arnold:
You know, I have a list of pet peeves, like urban myths that I'm just like, shake my head. No, that's not real. Do you have some for breastfeeding? Stuff that you're just like: Oh, I can't believe people believe this.

Leeann Moses:
That's a good question. Not really off the top of my head. Just making sure moms know that they can make milk. I mean, like you addressed earlier. Yes, there are some situations, but most of the time the stories I hear, you know, if we could have counseled with them or worked with them, maybe there was something that was missed. I'll have to think about that one for next time.

Dr. Arnold:
Next August, the first week will be world breast feeding week again, and we can bring you back for that.

Leeann Moses:
Yes, exactly.

Dr. Arnold:
Final question, why did you become interested in lactation?

Leeann Moses:
So I've been a nurse here now for 13 years and as a postpartum nurse in the women and children's center, I just loved helping these women breastfeed. And like I touched on earlier, just being that one that kind of gets that baby to actually latch and seeing how happy that makes them. And then I currently, I have three children and I'm currently nursing my third child. And for me personally, it's just been a great experience and it's something I'm very proud of and the bonding. And so I really wanted to help moms who wanted to do this, do it as well. So it's just been very rewarding for me.

Dr. Arnold:
Well, that's awesome. This is great information. Once again, this is Leeann Moses, lactation specialist at St. Luke's Birth Care Center. For more information visit UnityPoint.org. Thank you for listening to LiveWell Talk On. If you enjoyed this episode, don't forget to subscribe. And if you want to spread the word, please give us a five-star review and tell your family, friends, neighbors, strangers about our podcasts. We're available on Apple Podcast, Spotify, Pandora, or wherever you get your podcast. Until next time, be well.